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J Allergy Clin Immunol. 2017 Oct;140(4):933-949. doi: 10.1016/j.jaci.2017.04.024. Epub 2017 May 10.

NIAID, NIEHS, NHLBI, and MCAN Workshop Report: The indoor environment and childhood asthma-implications for home environmental intervention in asthma prevention and management.

Author information

1
Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass. Electronic address: diane.gold@channing.harvard.edu.
2
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass.
3
David Hide Asthma and Allergy Research Centre, Isle of Wight, and Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
4
Division of Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pa.
5
Indoor Biotechnologies, Charlottesville, Va.
6
Centers for Disease Control and Prevention (CDC), National Center for Environmental Health, Division of Environmental Hazards and Health Effects | Air Pollution and Respiratory Health Branch, Atlanta, Ga.
7
Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
8
Section of Paediatrics and MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, United Kingdom.
9
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
10
Departments of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
11
Department of Public Health Sciences, Henry Ford Hospital & Health System, Detroit, Mich.
12
Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill, NC.
13
Yale School of Public Health, Yale School of Medicine, Yale School of Forestry and Environmental Studies, Center for Perinatal, Pediatric and Environmental Epidemiology (CPPEE), New Haven, Conn.
14
Rho Federal Systems Division, Rho, Inc, Chapel Hill, NC.
15
Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass.
16
Genome Integrity and Structural Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
17
Pulmonary Center, Boston University School of Medicine, Boston, Mass.
18
Division of Allergy-Immunology and Rheumatology, Department of Pediatrics, Augusta University, Augusta, Ga.
19
Asthma, Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
20
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Ill.
21
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY.
22
Departments of Medicine and Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
23
Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
24
Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Md.
25
Division of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, Mass.
26
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga.
27
Division of Pediatric Allergy/Immunology, Johns Hopkins University, Baltimore, Md.

Abstract

Environmental exposures have been recognized as critical in the initiation and exacerbation of asthma, one of the most common chronic childhood diseases. The National Institute of Allergy and Infectious Diseases; National Institute of Environmental Health Sciences; National Heart, Lung, and Blood Institute; and Merck Childhood Asthma Network sponsored a joint workshop to discuss the current state of science with respect to the indoor environment and its effects on the development and morbidity of childhood asthma. The workshop included US and international experts with backgrounds in allergy/allergens, immunology, asthma, environmental health, environmental exposures and pollutants, epidemiology, public health, and bioinformatics. Workshop participants provided new insights into the biologic properties of indoor exposures, indoor exposure assessment, and exposure reduction techniques. This informed a primary focus of the workshop: to critically review trials and research relevant to the prevention or control of asthma through environmental intervention. The participants identified important limitations and gaps in scientific methodologies and knowledge and proposed and prioritized areas for future research. The group reviewed socioeconomic and structural challenges to changing environmental exposure and offered recommendations for creative study design to overcome these challenges in trials to improve asthma management. The recommendations of this workshop can serve as guidance for future research in the study of the indoor environment and on environmental interventions as they pertain to the prevention and management of asthma and airway allergies.

KEYWORDS:

Asthma; allergy; child health; clinical trials; environmental intervention; indoor allergens; pollutants

PMID:
28502823
PMCID:
PMC5632590
[Available on 2018-10-01]
DOI:
10.1016/j.jaci.2017.04.024
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